Accessory for surgical retractor



Jan. 23, 1968 c. c. HUNNICUTT 3,364,919

ACCESSORY FOR SURGICAL RETRACTOR Filed June 1965 I INVENTOR. 626/7 61Harm/cuff BY d3.

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United States Patent Ofi rice 3,3643% Patented Jan. 23, 1968 3,364,919ACCESSORY FOR SURGICAL RETRACTOR Cecil C. Hunnicutt, Sabetha, Kans.,assignor to Instrument Research, Inc., Sabetha, Kans., a corporation ofKansas Filed June 8, 1965, Ser. No. 462,191 6 Claims. (Cl. 128-20)ABSTRACT OF THE DISCLOSURE This application discloses an accessory for aBalfour retractor for enlarging and forming a surgical incision whichhas been spread by the fingers of the retractor. It comprises a fiatstrap curved transversely to its plane and transversely to the generalextent of said fingers so as to lie within the incision, and means forattaching the respective ends of said strap to the fingers of theretractor.

This invention relates to new and useful improvements in surgicalretractors, and has particular reference to an accessory for a surgicalretractor commonly known as a Balfour retractor. The Balfour retractorconsists of a frame carrying a pair of arms for relative movementthereon, each arm having a laterally projecting finger at the free endthereof, said fingers being insertable in a surgical incision andseparable by relative movement of said arms on said frame to hold theedges of said incision apart to provide a clear operating fieldtherebetween in which the surgeon can operate. This is a commonly usedtype of retractor, particularly in abdominal operations.

The principal objects of the present invention are the provision of anaccessory attachment for a Balfour retractor which will increase thesize of the clear operating field provided thereby, and will provide foroperating fields of odd or irregular shapes whenever such may benecessary, desirable or convenient for the surgeon.

Other objects are simplicity and economy of construction, and efficiencyand dependability of operation.

With these objects in View, as well as other objects which will appearin the course of the specification, reference will be had to theaccompanying drawing, wherein:

FIG. 1 is a top plan view of a Balfour surgical retractor, with anaccessory embodying the present invention shown in operativerelationship thereto,

FIG. 2 is a sectional view taken on line II-H of FIG. 1,

FIG. 3 is a laid-out face view of the retractor accessory as shown inFIGS. 1 and 2,

FIG. 4 is an edge view of the accessory as shown in FIG. 3,

FIG. 5 is a fragmentary view similar to FIG. 3 but showing aslightlymodified construction, and

FIG. 6 is an edge view of the modified construction shown in FIG. 5.

Like reference numerals apply to similar parts throughout the severalviews, and the numeral 2 applies generally to a Balfour surgicalretractor of a common type. It consists essentially of a framecomprising a pair of parallel, spaced apart slide bars 4 and 6 of squarecrosssectional contour having corresponding ends thereof joined rigidlytogether respectively by connector bars 8 and 10. Bar 8 is permanentlyjoined to bars 4 and 6, While bar 10 is detachably connected to bars 4and 6 by knurled nuts 12 in order that the various members to be carriedby the slide bars may be removed and replaced. Extending laterally fromslide bars 4 and 6, in the plane thereof, are a pair of elongated arms14 and 16. Arm 14 is integral with and forms an extension of connectorbar 8, while arm 16 is affixed to a short tubular sleeve 18 mountedslidably on slide bar 6. Sleeve 18 is sufficiently short, and

sufiiciently loose on bar 6, that any force applied to the free ends ofarms 14 and 16, tending either to move said arms closer together orfarther apart, will cause said sleeve to bind on bar 6 and lock againstmovement thereon. On the other hand, force applied to arm 16 closelyadjacent bar 6 will cause said sleeve to slide freely along the bar. Anextension of arm 16 between bars 4 and 6 constitutes a finger grip 20 bymeans of which force may conveniently be applied to move arm 16 awayfrom arm 14. Another sleeve 22 similar to sleeve 18 is slidably mountedon slide bar 4, to which auxiliary instruments may be attached by meansof wing nut 24, but this is not pertinent to the present invention.Afiixed respectively to the free ends of arms 14 and 16 are a pair offingers 26 and 28, said fingers extending transversely to the planeestablished by arms 14 and 16. As shown, each of said fingersconstitutes a loop of heavy wire or rod stock having its ends welded orotherwise affixed to the associated arm. In some retractors, on theother hand, said fingers constitute imperforate strips of sheet metal,such as stainless steel.

The structure thus far described constitutes a standard Balfourretractor, which is of course well known and in common use. Inapplication, the frame 2 is rested on the patients body adjacent asurgical incision, or on any other suitable support, and with arms 14and 16 disposed in close juxtaposition, the fingers 26 and 28 areinserted into the incision with arms 14 and 16 extending generallyparallel to the incision. The arms are then moved relatively apart bysliding sleeve 18 along bar 6, using finger grip 29 as a handle,whereupon fingers 26 and 28 draw the edges of the incision apart toclear an operating field therebetween in which the sungeon may work.However, this type of retractor has the disadvantage that, due to thenarrowness of the fingers 26-23, the incision tends to close at evenrather short distances from the fingers, along the axis of the incision,with the result that the size of the clear operating field providedthereby is rather limited. Also, the shape or contour of the openingprovided thereby is generally dictated by the natural resiliency of thepatients tissues as they try to recover from the distention caused bythe retractor, while the surgeon may for convenience actually need anopening of a different shape or contour. If it is attempted to enlargethe opening by separating arms 14 and 16 still farther, the distentionat the fingers themselves will of course be greater than would have beenrequired if said opening could have been shaped to the desired size andcontour by other means, and the operative damage to the tissues may beincreased.

In order to overcome these difiiculties, the present inventioncontemplates an accessory for the retractor thus far described, saidaccessory comprising a generally rectangular strap 39 of sheet metal orthe like, said strap having a post 32 affixed thereto adjacent each endthereof and extending at right angles to the plane thereof, both in thesame direction, each post having an enlarged knob 34 at the outer orfree end thereof. As indicated in FIGS. 1 and 2, strap 30 may be formed,transversely to its plane, into a generally semi-circular form, withposts 34 extending inwardly relative to said curvature. In use, saidstrap is then inserted into the incision of the patient in such a mannerthat posts 32 project inwardly in opposed relation through the loopsconstituting fingers 26 and 28. Said fingers thus support the strapagainst being collapsed or compressed by the pressure of the patientsbodily tissues 'thereagainst, and the inclusion of posts 32 in thefinger loops prevents any appreciable shifting of the strap relative tothe fingers. Knobs 34 assist in preventing any accidental dislodgment ofposts 32 from the fingers. It will be apparent that if fingers 26-28were of the type consisting of spatulate fingers of sheet metal,apertures could be drilled or otherwise formed therein to receive posts32.

Thus it will be readily apparent that strap 30 forms a dam for holdingback the patients tissues and organs within the incision, and provides amuch larger clear operating field than would be possible without itsuse, and without requiring a greater separation between the'fingers.

Strap 36 could be rigid and preformed to varous. sizes and shapes, andmade available in sets, so that the surgeon could select the one withthe size and shape desired for any given set of circumstances. However,said strap is' preferably formed of a met'al'which is sufficientlymalleable and ductile that it may be formed to any desired contour bythe application of substantial manual force thereto. With this type ofstrap the surgeon can form it in whatever contour he may desire in anyparticular case, and the number of straps required will be greatlyreduced, although straps of different lengths and Widths may still benecessary.

The accessory strap 30 thus far described will commonly be used with asurgical lap sponge 36 constituting a thick fiat layer of fibrousmaterial, said lap sponge overlying and completely covering the outerconvex surface of the strap, and being held thereagainst by the pressureof the patients body. In order to prevent any possible slippage ordisplacement of the sponge relative to the strap, the strap has a seriesof holes 38 formed therethrough in longitudinally spaced apart relationthroughout its length. Sponge 36, particularly as it becomes saturatedwith the patients bodily fluids, tends to bulge through said holes asshown at 40 in FIG. 2, thereby anchoring said sponge and strap againstrelative movement. As shown, holes 38 are disposed in two rows disposedrespec-. tively adjacent the opposite longitudinal edges of the strap.The holes of the two rows are staggered .lon gitudinally of the strap asshown in FIG. 3, in order that any fold line which may be formedtransversely across the strap as it is manually formed as discussedabove can intersect only one of said holes. This reduces thepossi'bility that the strap will be fractured by work fatigue.

FIGS. 5 and 6 show a slightly modified form of strap,

designated by the numeral 39. It is identical to that shown in FIGS. 14except that it is ofone-piece construction, the elements 42 thereofcorresponding to posts 32 in FIGS. 1-4 being formed by bent-upextensions integral with the body portion of the strap. At its outerend, each element 42 is bent over to'form a short ear 44 forming anenlargement having the same function as the knobs 34 in FIGS. 1-4.

While I have shown and described certain specific embodiments of myinvention, it willjbe readily apparent that many minor changesof'structure and operation could be made without departing from thespirit of the inven: tion as defined by the scope ofthe appended claims,

What I claim as new and desire to protect by Letters 1. In combinationwith a surgical retractor consisting 55 Patent is:

ofv a pair of fingers carried for relative movement by a frame andinserta ble in a surgical incision,-said fingers. being separable byrelative movement thereof on said. frame to separatethe walls of saidincision, an accessory.

comprising:

(a) an elongated strap of sheet material the plane of which is generallyparallel to the longitudinal extent of said fingers and which is curvedtransversely to its own plane in a plane generally at right angles tosaid fingers, and

(b). means attaching the opposite ends of said strap respectively tosaid fingers.

2. The combination as recited in claim 1 wherein said strap is formed ofa soft, malleable material capable of being formed manually to anydesired contour.

3. In combination with asurgical retractor consisting of a pair offingers carriedjfor relative movement by a frame and insertable in asurgical incision, said fingers being separable by relative-movementthereof on said frame to separate the walls of said incision, each ofsaid fingers having an aperture formed therethrough and opening along .aline interconnecting said fingers, an accessory comprisingz' (a) anelongated strap of sheet material the plane of which is generallyparallel to the longitudinal extent of said fingers and which is curvedtransversely to its own plane in a planegenerally at right 'angles tosaid fingers, and Y (b) means attaching the opposite ends of said straprespectively to said fingers, said means comprising a pair of postsaflixed to said strap respectively adjacent opposite ends thereof andextending generally at right angles to the plane thereof, each of saidposts being insert able in the aperture of the associated finger.

4. The combination as recited in claim 3 wherein each of said posts isprovided at its free end with an enlargement aflixed thereto,.saidenlargementbeing sufficently small to pass through the aperture of theassociated finger.

5. In combinationwith asurgical retractor consisting of a pair offingers carried for relative movement by a V l frameand insertable in asurgical incision, said fingers being separable by relative movementthereof on said frame to separate the walls of said incision, anaccessory comprising:

(a) an elongated strap of sheet material the plane of .whichis generallyparallel'to the longitudinal extent ofsaid fingers and which is curvedtransversely to its own plane in a plane generally at right angles tosaid fingerssaid-strap having a series of holes a formed therethroughwhereby a surgical sponge pressed thereagainst will tend to bulgethrough said holes to anchor said sponge against sliding movement onsaid strap, and

(b) means attaching the opposite ends of said strap V respectively tosaid fingers.

6. The combination as recited in claim 5 wherein said strap is formed of=a'soft, malleable material, and wherein said holesare spaced .apartlongitudinally of said strap, whereby anyqtransverse fold line acrosssaid strap can intersect no more than one of said holes.

References Cited I UNITED STATES PATENTS 458,804 9/1891 Ellis 128891,944,009 1/193 4 Homer 128-20 2,313,164 3/1943 Nelsoni 12s--2o3,168,093 2/1965 Gauthier 12s 20 3,288,131 11/1966 Garland '12s. 20

* FOREIGN PATENTS 483,394 7/1953 Italy.

RICHARD A. GAUDET, Primary Examiner.

K. L. HOWELL, Assistant Examiner.

